There has been a large debate in Washington D.C. on how effective the Affordable Cares Act has been in revitalizing America’s healthcare ecosystem. There were many reasons to implement the ACA and one of the reasons that stood out to me the most was the idea that the United States placed dead last among developed countries in terms of mortality rate. The United States spends more than twice the amount than the rest of the world combined on healthcare but yet our nation still has a very low life expectancy. People generally come and think of America as the best place to get healthcare due to the technological advances our country has made in healthcare. However, to access these benefits, one would either have to shell out a lot of money or get lucky and have their provider give them the service that they were looking for. With the ACA, we move one step closer to a healthier society.

For example, before the ACA, hospitals were losing a lot of money because they had an overflow of emergency room patients and not enough people were making time to see their doctors regularly on a yearly basis. In addition, since the hospitals were not able to get money out of the emergency-room patients due to lack of financial status of the patient, hospitals would charge those who had insurances higher costs to balance the money being lost from the uninsured patients. That effect then raises the premium for the individual with the insurance and they end up having to pay for those without insurances.

With universal healthcare, the predicament listed above ends. Everyone will be mandated to have health insurance and hospitals will be able to save generate more money from patients. I do not believe that the quality of healthcare would go down in this world but rather everyone would have access to the healthcare technologies that currently exist. Healthcare should not be limited to one socioeconomic group because all people should have equal rights in terms of care in my opinion.

Another major part of the new healthcare reform is a greater emphasis on preventative care. Great Britain has less than half the U.S. budget on healthcare but they do not focus on spending money to develop drugs. Britain focuses their money on developing preventative medicine policies so that they can stop disease earlier in its cycle in order to prevent spread of the disease. I believe that U.S. can be smarter with how it utilizes its funds and continue to build upon the foundation the new healthcare reform has set up.

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Brody and T. Engelhard, “Access to Health Care,” Bioethics: Readings and Cases

In the past blogs, the idea of non-maleficence vs autonomy has been discussed to determine a course of action for a patient. However, this week, the readings look at the idea of beneficence and its role in guiding decisions. While the principle of non-maleficence tells us to not harm the patient, the principle of beneficence demands that an actor also perform positive steps to help a patient. For this week’s blog, I read the case involving the dialogue between Dax Cowart and Robert Burt. After a propane gas explosion, Dax’s father had died but Dax had been admitted into the hospital for treatment. However, throughout his treatment Dax made claims of wanting to die rather than to continue living. He tried to take his own life on multiple occasions and it was evident that he was in immense pain. However the doctors refused to let him die and treated him until he was able to carry out day to day tasks on his own.

This case study looks at the dilemma the doctors were presented with on whether treating Dax had been the correct decision. Dax’s autonomy had been violated but the doctor’s acted appropriately when accounting for the principle of beneficence. The dilemma of this case revolves around the idea of whether the patient’s right to die needs to be respected. Though he had been labeled as clinically competent, doctors did not agree with Dax’s terms of dying even though Dax wanted them to stop treating him. Dax may have been viewed as being too emotional to weigh the costs and benefits of treatment due to his dad’s recent death but being labeled as  clinically competent puts an interesting twist on this case. It could be argued that it was Dax’s autonomous decision to die and the doctor’s decision not to respect that wish violates a moral parameter.

By comparing the principle of beneficence to the principle of autonomy, I believe that the doctors made the right decision in treating Dax. The doctors followed their own moral compass on not only conducting actions that were to the benefit of the patient but also not putting the patient in greater harm. When admitted into the hospital, Dax was very emotional due to the family death. However, the achievements that Dax accomplished after his treatments and his changed view of life show that the doctors made the right decision. Though Dax’s autonomy had been violated, the decision his clinical providers made turned out to impact Dax’s life in a positive way both physically and with his new career maybe even mentally.

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. Seventh ed. New York, NY: Oxford UP, 2001. Print.

Cowart, Dax, and Robert Burt. “Confronting Death Who Chooses, Who Controls?” JSTOR. The Hastings Center, n.d. Web. 18 Mar. 2015. <http://www.jstor.org/stable/3527969>

In this week’s blog, I analyzed the reading discussing the idea of autonomy vs. pressure from family to make a decision about health.  The case that I looked at was Mr. M’s. He was admitted into the intensive care unit because of respiratory issues. Initially he had told the doctor that he did not want anything extraordinary done regarding procedures that may resuscitate him. However, his wife intervened and said Mr. M needs anything that can be done to extend his life and Mr. M changed his mind about his initial decision after speaking to his wife. The doctor believed that Mr. M’s autonomy had been compromised and as a result this case looks at familial pressures on autonomy.

The main dilemma in this case has to deal with whether the patient deserves an autonomous decision or if familial help is necessary to make a decision. When facing tough decisions in a weakened state, a patient relies heavily on their support system (family) to help them through tough times. Doctors thus need to be able to identify if a patient is making an autonomous decision during their vulnerable state while maintaining respect for the patient’s full entourage.

While looking at both sides, I believe the doctor should prefer to take the patient’s autonomous choice into account when making clinical decisions. This statement is particularly true when a patient has full control over their mind and is able to make decisions for themselves. In today’s diverse world, there are many different types of support groups that patients surround themselves with which are outside of the standard family concept. Doctors must be able to abide the principle of non-maleficence when handling the patients by doing no harm. A doctor’s relationship with a patient has a holistic point to it and comes from both being respectful to the patient and their body. By respecting a patient’ s familial concerns while keeping the interest of the patient in mind, doctor’s can make a decision with respecting both the principle of autonomy and non-maleficence. In the case of Mr. M, I believe that the doctor should respect what he wants to do even if he suspects coercion by the wife.

Works Cited

Ho, Anita. “Relational Autonomy or Undue Pressure? Family’s Role in Medical Decision-making.” Scandinavian Journal of Caring Sciences 22.1 (2008): 128-35. Web.

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Autonomy is one of the main moral principles. Beauchamp and Childress discuss how respecting autonomous agents involve acknowledging an individuals right to make choices and to take actions based on their values and beliefs. There are many elements that go into describing the principle of autonomy. The most present example of autonomy lies in the idea of informed consent.

Informed consent goes hand and hand with medicine these days. It is a concept that ties well with the principle of autonomy because it allows an individual an opportunity to satisfy the three condition theory (Beauchamp and Childress). In Principles of Biomedical Ethics, Beauchamp and Childress point out that there are three conditions that comprise the principle of autonomy. Choosers that display autonomy should act intentionally, with understanding, and without controlling influences that determine action. Intentional actions do not have to evoke a positive outcome; often times undesired outcomes are part of an intentional action. The point is to see that there was value in the decision made. In terms of understanding, an action should not be labeled as being autonomous if the individual does not adequately understand it. Poor understanding can be caused by absence of information  and deficiencies in the communication process. Finally, a person should be free of both internal and external sources that my take away from an individual’s self determination.

There are various cases that can allude to informed consent. The major paradox in the American healthcare system is the criticism that doctors do too many tests/procedures. However, the reason for the quantity of tests may not be due to just simply profit as many capitalists might have you believe but rather the nature of our Judicial system. Throughout American history, there have been numerous examples of doctors being held liable for their patients.

An example case could involve a surgeon doing a simple biopsy on a patient. This biopsy will be performed with the doctor obtaining informed consent. However, during the surgery, the doctor discovers a threatening tumor. The ethics behind this situation are important because the doctor can either choose to leave the tumor or take it out. The patient would have already been induced into a coma so there would be no autonomy on the patient’s side to choose what they would want (Murray). The doctor is then left with the choice of taking out the tumor but not following informed consent or leaving it alone. The situation is tough because if the doctor does take the tumor out, he stands to be liable because the patient had not given him permission to take out the tumor.

In my opinion, I would leave the tumor in the body and not risk having a malpractice lawsuit aimed at me. The tumor could be taken care of at a later time when proper protocols have been met. My decision is driven mainly by autonomy concerns of the patient and I believe that their thought process on the matter is what matters most. Thus, we must support the patient.

Works Cited:

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Murray, Peter M. “The History of Informed Consent.” The Iowa Orthopaedic Journal 10 (1990): 104–109. Print.